“Frail nursing home patients told to relocate as their Medi-Cal plans cut off payment,” by Jocelyn Wiener, California Healthline
“Some of California’s most vulnerable nursing home residents, many of whom have nowhere else to go, are receiving letters from their health care plans saying they are no longer eligible for long-term care. In one notable example, three dozen nursing home residents in San Luis Obispo County were informed on the same day that their Medi-Cal managed care plan was cutting off payment for nursing home care, said Karen Jones, the county’s long-term care ombudsman.”
LTC Comment (from Stephen A. Moses, President, Center for Long-Term Care Reform):
What a surprise. Private managed care plans enforce Medicaid eligibility rules more accurately than state government Medicaid eligibility workers. State workers have no financial incentive to make sure recipients are really eligible. Managed care plans have a strong incentive to do so. Expect more stories like this one.